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See a sample rate comparisonCPT 25443 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Arthroplst W/ Prosthet Replac; Scaphoid Carpal (Navicular), Arthroplasty With Prosthetic Replacement; Scaphoid Carpal (Navicular)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 25443 |
| Medicaid Fee Schedule | View Medicaid rates for 25443 |
National average reimbursement for CPT 25443 by major payers:
$1,136.34
$1,054.48
$1,068.06
$1,287.20
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CPT 25443
5 of 25 sample ratesHigher to lower in this preview
Lehigh Valley Hospital Muhlenberg
Lehigh Valley Hospital
$23,947.86Published rateTucson Digestive Institute LLC, Arizona Digestive Institute
$5,020.00Published rateSeattle Pain Relief PLLC, Federal Way Ambulatory Surgical Facility
Seattle Pain Relief PLLC
$3,200.00Published rateTallgrass Surgical Center, LLC
$2,200.00Published rateMelbourne Asc Lp, The Surgery Center Of Melbourne
Melbourne Asc Lp
$410.00Published rate
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See a sample payer proposalCPT 25443 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25443 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 25443 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 25443-CPT | High | Arthroplst W/ Prosthet Replac; Scaphoid Carpal (Navicular), Arthroplasty With Prosthetic Replacement; Scaphoid Carpal (Navicular) |
| 25444-CPT | High | Wrist Joint Replacement, Surgery To Replace Worn Out Ends Of Wrist Joint With An Artificial Part (Prosthesis). |
| 25445-CPT | High | Arthropl.W/Prosth Replac;Trapezium |
| 25446-CPT | High | Arthroplst W/ Prosthet Replac; Distal Radius & Partial Or, Arthroplasty With Prosthetic Replacement; Distal Radius And Partial Or |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25443. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25443 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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